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在全球范围内,因肺癌导致的死亡人数逐渐上升[1-2],其中,非小细胞肺癌(non-small cell lung cancer,NSCLC)是最常见的肺癌类型,其主要包括鳞状细胞癌(squamous-cell carcinoma,SCC)、腺癌和大细胞癌。细胞增殖核抗原Ki-67(简称Ki-67)存在于多种恶性肿瘤增殖细胞中,是一种已知的预后指标[3-5]。Ki-67增殖指数在组织病理学检查和穿刺细胞学检查时可能存在偏差,不能很好地反映肿瘤细胞的增殖情况,且其属于有创性检查,可重复性差[4]。因此,寻找一种有效、可无创表征肿瘤细胞增殖的方法至关重要。18F-FDG PET/CT代谢参数可间接反映NSCLC细胞的增殖状态,有作为NSCLC特定组织病理学检查生物标志物的可视化、非侵入性替代标志物的潜力[6-8]。NSCLC肿瘤内或肿瘤间的异质性导致Ki-67增殖指数出现偏差,且NSCLC不同病理亚型Ki-67的表达亦有所不同[7],因此,Ki-67增殖指数与18F-FDG PET/CT代谢参数是否有相关性仍存在争议。我们回顾性分析NSCLC不同病理亚型的Ki-67增殖指数与18F-FDG PET/CT代谢参数的相关性,旨在为临床医师提供参考。
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134例NSCLC患者中,腺癌89例(浸润型腺癌85例、变异型腺癌4例)、SCC 45例(非角化型SCC 19例、角化型SCC 24例、基底样SCC 2例)。由表1可知,除年龄、性别的MTV外,不同临床特征的Ki-67增殖指数、18F-FDG PET/CT代谢参数间的差异均有统计学意义(均P<0.01)。
特征 例数(%) Ki-67
( ,%)$\bar x\pm s $ Z值(P值) SUVmax
( )$\bar x\pm s $ Z值(P值) MTV
( ,cm3)$\bar x\pm s $ Z值(P值) TLG
( ,g)$\bar x\pm s $ Z值(P值) 年龄 0.239(0.811) 0.808(0.419) 0.287(0.774) 0.603(0.546) ≥65岁 69(51.5) 32.5±24.2 11.1±7.8 16.2±17.7 159.6±266.5 <65岁 65(49.5) 32.8±23.6 11.5±6.5 15.9±19.5 136.0±213.5 性别 6.022(<0.001) 5.473(<0.001) 1.332(0.183) 4.306(<0.001) 男 86(64.2) 41.0±21.7 13.7±6.7 18.5±20.8 196.7±281.1 女 48(35.8) 17.2±19.3 7.0±5.8 11.5±12.8 61.2±104.1 肿瘤
分期4.002(<0.001) 5.075(<0.001) 4.836(<0.001) 5.871(<0.001) Ⅰ+Ⅱ 93(69.4) 27.0±23.0 9.1±5.9 10.7±11.8 66.7±110.9 Ⅲ 41(30.6) 43.0±21.0 16.4±7.2 28.2±24.6 326.2±344.5 肿瘤
大小4.605(<0.001) 5.857(<0.001) 7.551(<0.001) 8.236(<0.001) ≥3 cm 73(54.5) 39.8±23.1 14.5±6.6 24.2±21.7 244.7±286.0 <3 cm 61(45.5) 22.3±21.6 7.6±6.0 6.3±5.1 32.7±82.7 病理
亚型6.026(<0.001) 5.912(<0.001) 2.634(0.008) 4.892(<0.001) 腺癌 89(66.4) 23.7±21.3 8.9±6.8 12.6±15.6 99.6±228.5 鳞状
细胞癌45(33.6) 49.0±18.3 16.1±5.3 22.8±21.2 243.8±241.1 淋巴结转移 3.908(<0.001) 4.610(<0.001) 2.997(0.003) 4.828(<0.001) 阴性 90(67.2) 42.3±20.1 9.3±6.6 12.6±16.1 98.9±194.9 阳性 44(32.8) 26.8±24.4 15.4±6.6 22.5±21.5 249.0±293.7 CT形态学特征 45.474(<0.001) 70.042(<0.001) 62.331(<0.001) 84.842(<0.001) 团块 70(52.2) 42.0±21.5 15.4±6.2 24.9±22.0 263.8±290.3 结节 43(32.1) 28.7±22.3 9.2±4.9 5.0±3.3 26.8±21.3 磨玻璃结节 21(15.7) 7.0±5.2 2.1±0.8 9.0±3.9 11.4±8.1 注:Ki-67为细胞增殖核抗原;FDG为氟脱氧葡萄糖;PET为正电子发射断层显像术;CT为计算机体层摄影术;SUVmax为最大标准化摄取值;MTV为肿瘤代谢体积;TLG为糖酵解总量 表 1 134例非小细胞肺癌患者不同临床特征的Ki-67增殖指数、18F-FDG PET/CT代谢参数间的比较
Table 1. Comparison of Ki-67 proliferation index and 18F-FDG PET/CT metabolic parameters among different clinical features of 134 patients with non-small cell lung cancer
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由表2可知,浸润型腺癌患者不同病理亚型的Ki-67增殖指数、SUVmax间的差异均有统计学意义(均P<0.001)。由表3可知,不同分化程度浸润型腺癌患者的Ki-67增殖指数、SUVmax、TLG间的差异均有统计学意义(均P≤0.001),贴壁为主型腺癌的SUVmax明显低于其他类型腺癌,尤其是低于实体+微乳头状为主型腺癌(图1)。由表4可知,SCC患者不同病理亚型的Ki-67增殖指数、MTV、TLG间的差异均有统计学意义(均P<0.05)。
病理亚型 Ki-67(%) SUVmax MTV(cm3) TLG(g) 贴壁为主型(n=22) 9.0±7.0 3.9±3.7 7.5±4.2 16.8±20.4 腺泡为主型(n=28) 24.0±21.9 8.4±5.4 12.2±14.2 66.5±105.3 乳头状为主型(n=12) 18.0±13.0 7.4±4.1 8.9±7.1 46.4±55.3 微乳头状为主型(n=9) 41.0±19.0 16.0±8.9 17.1±16.9 257.0±444.6 实体为主型(n=14) 36.0±18.9 13.5±5.5 15.7±12.2 153.4±150.3 Z值 26.403 32.372 6.837 0.870 P值 <0.001 <0.001 0.145 0.929 注:Ki-67为细胞增殖核抗原;FDG为氟脱氧葡萄糖;PET为正电子发射断层显像术;CT为计算机体层摄影术;SUVmax为最大标准化摄取值;MTV为肿瘤代谢体积;TLG为糖酵解总量 表 2 85例浸润型腺癌患者不同病理亚型的 Ki-67增殖指数、18F-FDG PET/CT代谢参数的比较(
)$ \bar x\pm s $ Table 2. Comparison of Ki-67 proliferation index and 18F-FDG PET/CT metabolic parameters in different pathological subtypes of 85 patients with invasive adenocarcinoma (
)$ \bar x\pm s $ 分化程度 Ki-67(%) SUVmax MTV(cm3) TLG(g) 高分化型(n=22, 贴壁为主型) 9.0±7.0 3.9±3.7 7.5±4.2 16.8±20.4 中分化型(n=40, 腺泡+乳头状为主型) 22.1±20.2 8.1±5.1 11.2±12.8 60.5±94.9 低分化型(n=23, 实体+微乳头状为主型) 37.5±19.7 14.4±7.3 16.3±14.6 194.0±312.9 Z值 21.074 21.410 1.903 13.983 P值 <0.001 <0.001 0.386 0.001 注:Ki-67为细胞增殖核抗原;FDG为氟脱氧葡萄糖;PET为正电子发射断层显像术;CT为计算机体层摄影术;SUVmax为最大标准化摄取值;MTV为肿瘤代谢体积;TLG为糖酵解总量 表 3 85例不同分化程度浸润型腺癌患者的 Ki-67增殖指数、18F-FDG PET/CT代谢参数的比较(
)$ \bar x\pm s $ Table 3. Comparison of Ki-67 proliferation index and 18F-FDG PET/CT metabolic parameters in different differentiation degrees of 85 patients with invasive adenocarcinoma (
)$ \bar x\pm s $ 病理亚型 Ki-67(%) SUVmax MTV(cm3) TLG(g) 非角化型(n=19) 50.0±15.0 18.1±5.5 33.4±20.3 386.2±276.6 角化型(n=24) 43.0±18.0 14.7±5.6 19.1±23.3 189.9±222.6 基底样(n=2) − − − − Z值 2.096 1.736 2.177 2.494 P值 0.036 0.082 0.030 0.013 注:Ki-67为细胞增殖核抗原;FDG为氟脱氧葡萄糖;PET为正电子发射断层显像术;CT为计算机体层摄影术;SUVmax为最大标准化摄取值;MTV为肿瘤代谢体积;TLG为糖酵解总量。−表示无此项数据 表 4 45例鳞状细胞癌患者不同病理亚型的 Ki-67增殖指数、18F-FDG PET/CT代谢参数的比较(
)$ \bar x\pm s $ Table 4. Comparison of Ki-67 proliferation index and 18F-FDG PET/CT metabolic parameters in different pathological subtypes of 45 patients with squamous cell carcinoma (
)$ \bar x\pm s $ 图 1 浸润型腺癌不同病理亚型的18F-FDG PET/CT显像图 1A为贴壁为主型腺癌(女性,62岁),SUVmax=1.9,Ki-67增殖指数为5%;1B为腺泡为主型腺癌(女性,68岁),SUVmax=4.5,Ki-67增殖指数为25%;1C为乳头状为主型腺癌(男性,55岁),SUVmax=3.9,Ki-67增殖指数为19%;1D为实体为主型腺癌(女性,59岁),SUVmax=8.7,Ki-67增殖指数为50%;1E为微乳头状为主型腺癌(男性,68岁),SUVmax=12.1,Ki-67增殖指数为87%。1A~1E从左到右依次为高分辨率CT、PET、PET/CT显像图。FDG为氟脱氧葡萄糖;PET为正电子发射断层显像术; CT为计算机体层摄影术;SUVmax为最大标准化摄取值;Ki-67为细胞增殖核抗原 图2 134例非小细胞肺癌患者的Ki-67增殖指数与18F-FDG PET/CT代谢参数的相关性 Ki-67为细胞增殖核抗原;FDG为氟脱氧葡萄糖;PET为正电子发射断层显像术;CT为计算机体层摄影术;SUVmax为最大标准化摄取值;MTV为肿瘤代谢体积;TLG为糖酵解总量
Figure 1. 18F-FDG PET/CT images of different pathological subtypes of invasive adenocarcinoma Figure 2 Correlation between Ki-67 proliferation index and 18F-FDG PET/CT metabolic parameters in 134 patients with non-small cell lung cancer
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134例NSCLC患者的Ki-67增殖指数与18F-FDG PET/CT代谢参数均呈线性正相关(均P<0.001),其中与SUVmax的相关性最高(图2)。
由表5可知,贴壁、腺泡和乳头状为主型腺癌的Ki-67增殖指数与SUVmax、TLG呈线性正相关(均P<0.05),但与TLG的相关性相对较低。实体为主型腺癌的Ki-67增殖指数与MTV、TLG呈线性相关(均P<0.01);微乳头状为主型腺癌的Ki-67增殖指数与18F-FDG PET/CT代谢参数均无相关性。根据Nakamura等[10]的研究结果进一步对有相似生物学行为的浸润型腺癌的病理亚型再归类分组分析后发现,高分化型腺癌(贴壁为主型)的SUVmax和TLG、中分化型腺癌(腺泡+乳头状为主型)的SUVmax与Ki-67增殖指数呈中度线性正相关(均P<0.05);低分化型腺癌(实体+微乳头状为主型)的SUVmax、MTV、TLG均与Ki-67增殖指数呈中度线性正相关(均P<0.05),且MTV、TLG较SUVmax与Ki-67增殖指数相关性更高。在SCC的2个亚型中,角化型SCC仅SUVmax与Ki-67增殖指数呈中度线性正相关(r=0.552,P=0.005);而非角化型SCC的SUVmax、MTV、 TLG与Ki-67增殖指数均无相关性(r=−0.041、−0.033、−0.066,P=0.869、0.894、0.789)。由于样本量较小,未能对4例变异型腺癌患者和2例基底样SCC患者进行分析。
Ki-67增殖指数 SUVmax MTV TLG r值 P值 r值 P值 r值 P值 不同病理亚型浸润型腺癌 贴壁为主型(n=22) 0.568 0.006 0.042 0.852 0.576 0.005 腺泡为主型(n=28) 0.719 <0.001 −0.289 0.136 0.491 0.008 乳头状为主型(n=12) 0.795 0.002 0.212 0.508 0.477 0.017 微乳头状为主型(n=9) 0.179 0.645 0.409 0.275 0.230 0.552 实体为主型(n=14) 0.408 0.148 0.722 0.004 0.682 0.007 不同分化程度浸润型腺癌 高分化型(n=22,贴壁为主型) 0.568 0.006 0.042 0.852 0.576 0.005 中分化型(n=40,腺泡+乳头状为主型) 0.671 <0.001 −0.106 0.515 0.083 0.612 低分化型(n=23,实体+微乳头状为主型) 0.492 0.017 0.652 0.001 0.603 0.002 注:Ki-67为细胞增殖核抗原;FDG为氟脱氧葡萄糖;PET为正电子发射断层显像术;CT为计算机体层摄影术;SUVmax为最大标准化摄取值;MTV为肿瘤代谢体积;TLG为糖酵解总量 表 5 85例浸润型腺癌患者不同病理亚型和分化程度的Ki-67增殖指数与18F-FDG PET/CT代谢参数的相关性
Table 5. Correlation of Ki-67 proliferation index and 18F-FDG PET/CT metabolic parameters in different pathological subtypes and differentation degrees of 85 patients with invasive adenocarcinoma
非小细胞肺癌不同病理亚型Ki-67增殖指数与18F-FDG PET/CT代谢参数的相关性
Correlation between Ki-67 proliferation index and 18F-FDG PET/CT metabolic parameters in different pathological subtypes of non-small cell lung cancer
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摘要:
目的 探讨非小细胞肺癌(NSCLC)不同病理亚型细胞增殖核抗原Ki-67(简称Ki-67)增殖指数与18F-氟脱氧葡萄糖(FDG) PET/CT代谢参数的相关性。 方法 回顾性分析2018年3月至2020年8月于武汉大学人民医院经组织病理学检查确诊为NSCLC的134例患者的临床资料,其中男性86例、女性48例,年龄39~85(63.9±9.1)岁。所有患者术前均行18F-FDG PET/CT和高分辨率CT(HRCT)显像。从PET/CT图像中提取代谢参数,包括最大标准化摄取值(SUVmax)、肿瘤代谢体积(MTV)、糖酵解总量(TLG);从HRCT图像中获取肿瘤大小和CT形态学特征。采用Mann-Whitney U 和Kruskal-Wallis检验比较不同临床病理特征间PET/CT代谢参数、Ki-67增殖指数的差异;采用Pearson和Spearman相关性分析对不同病理亚型的PET/CT代谢参数与Ki-67增殖指数进行相关性分析。 结果 134例NSCLC患者在肿瘤分期、肿瘤大小、病理亚型、淋巴结转移、CT形态学特征间的Ki-67增殖指数、SUVmax、MTV、TLG的差异均有统计学意义(Z=2.634~84.842,均P<0.001)。所有患者的Ki-67增殖指数与SUVmax、MTV、TLG均呈线性正相关(r=0.787、0.309、0.651,均P<0.001)。低分化型腺癌(实体+微乳头状为主型腺癌)的Ki-67增殖指数与SUVmax、MTV、TLG均存在相关性(r=0.492、0.652、0.603,均P<0.05);而高分化型腺癌(贴壁为主型腺癌)的SUVmax和TLG、中分化型腺癌(腺泡+乳头状为主型腺癌)的SUVmax 与Ki-67增殖指数呈线性相关(r=0.568、0.567、0.671,均P<0.05)。 结论 NSCLC的Ki-67增殖指数与18F-FDG PET/CT代谢参数SUVmax、MTV、TLG均有相关性,且与SUVmax的相关性最高。NSCLC不同病理亚型的Ki-67增殖指数与不同的18F-FDG PET/CT代谢参数相关性程度不同。 -
关键词:
- 癌,非小细胞肺 /
- 正电子发射断层显像术 /
- 体层摄影术,X线计算机 /
- 氟脱氧葡萄糖F18 /
- Ki-67抗原
Abstract:Objective To investigate the correlation between the proliferation index of proliferating nuclear antigen Ki-67 (called Ki-67) in different pathological subtypes of non-small cell lung cancer (NSCLC) and the metabolic parameters of 18F-fluorodeoxyglucose (FDG) PET/CT. Methods The clinical data of 134 patients with NSCLC diagnosed by histopathological examination in Renmin Hospital of Wuhan University from March 2018 to August 2020 were retrospectively analyzed. The patients included 86 males and 48 females, aged 39–85 (63.9±9.1) years old. All patients underwent 18F-FDG PET/CT and high-resolution CT (HRCT) imaging before surgery. Metabolic parameters, including maximum standardized uptake value (SUVmax), tumor metabolic volume (MTV), and total lesion glycolysis (TLG), were extracted from the PET/CT images. Tumor size and CT morphological features were obtained from the HRCT images. Mann-Whitney U and Kruskal-Wallis tests were used to compare the differences in PET/CT metabolic parameters and Ki-67 proliferation indexes among different clinicopathological features. Pearson and Spearman correlation analysis were used to correlate PET/CT metabolic parameters with Ki-67 proliferation index in different pathological subtypes. Results Significant differences were found in Ki-67 proliferation index, SUVmax, MTV, and TLG among the 134 NSCLC patients in terms of tumor stage, tumor size, pathological type, lymph node metastasis, and CT morphological features (Z=2.634–84.842, all P<0.001). The Ki-67 proliferation index in all patients was positively correlated with SUVmax, MTV, and TLG (r=0.787, 0.309, 0.651; all P<0.001). The Ki-67 proliferation index of poorly differentiated adenocarcinoma (solid + micropapillary predominant type) was correlated with SUVmax, MTV, and TLG (r=0.492, 0.652, 0.603; all P<0.05). However, the SUVmax and TLG in the well-differentiated adenocarcinoma group (adenocarcinoma predominantly adherent) and the SUVmax in the moderately differentiated adenocarcinoma group (acinar+papillary predominant adenocarcinoma) were correlated linearly with the Ki-67 proliferation index (r=0.568, 0.567, 0.671; all P<0.05). Conclusions The Ki-67 proliferation index of NSCLC was correlated with 18F-FDG PET/CT metabolic parameters SUVmax, MTV, and TLG. The highest correlation was obtained with SUVmax. The correlation degree of Ki-67 proliferation index with different 18F-FDG PET/CT metabolic parameters varied in different NSCLC pathological subtypes. -
图 1 浸润型腺癌不同病理亚型的18F-FDG PET/CT显像图 1A为贴壁为主型腺癌(女性,62岁),SUVmax=1.9,Ki-67增殖指数为5%;1B为腺泡为主型腺癌(女性,68岁),SUVmax=4.5,Ki-67增殖指数为25%;1C为乳头状为主型腺癌(男性,55岁),SUVmax=3.9,Ki-67增殖指数为19%;1D为实体为主型腺癌(女性,59岁),SUVmax=8.7,Ki-67增殖指数为50%;1E为微乳头状为主型腺癌(男性,68岁),SUVmax=12.1,Ki-67增殖指数为87%。1A~1E从左到右依次为高分辨率CT、PET、PET/CT显像图。FDG为氟脱氧葡萄糖;PET为正电子发射断层显像术; CT为计算机体层摄影术;SUVmax为最大标准化摄取值;Ki-67为细胞增殖核抗原 图2 134例非小细胞肺癌患者的Ki-67增殖指数与18F-FDG PET/CT代谢参数的相关性 Ki-67为细胞增殖核抗原;FDG为氟脱氧葡萄糖;PET为正电子发射断层显像术;CT为计算机体层摄影术;SUVmax为最大标准化摄取值;MTV为肿瘤代谢体积;TLG为糖酵解总量
Figure 1. 18F-FDG PET/CT images of different pathological subtypes of invasive adenocarcinoma Figure 2 Correlation between Ki-67 proliferation index and 18F-FDG PET/CT metabolic parameters in 134 patients with non-small cell lung cancer
表 1 134例非小细胞肺癌患者不同临床特征的Ki-67增殖指数、18F-FDG PET/CT代谢参数间的比较
Table 1. Comparison of Ki-67 proliferation index and 18F-FDG PET/CT metabolic parameters among different clinical features of 134 patients with non-small cell lung cancer
特征 例数(%) Ki-67
( ,%)$\bar x\pm s $ Z值(P值) SUVmax
( )$\bar x\pm s $ Z值(P值) MTV
( ,cm3)$\bar x\pm s $ Z值(P值) TLG
( ,g)$\bar x\pm s $ Z值(P值) 年龄 0.239(0.811) 0.808(0.419) 0.287(0.774) 0.603(0.546) ≥65岁 69(51.5) 32.5±24.2 11.1±7.8 16.2±17.7 159.6±266.5 <65岁 65(49.5) 32.8±23.6 11.5±6.5 15.9±19.5 136.0±213.5 性别 6.022(<0.001) 5.473(<0.001) 1.332(0.183) 4.306(<0.001) 男 86(64.2) 41.0±21.7 13.7±6.7 18.5±20.8 196.7±281.1 女 48(35.8) 17.2±19.3 7.0±5.8 11.5±12.8 61.2±104.1 肿瘤
分期4.002(<0.001) 5.075(<0.001) 4.836(<0.001) 5.871(<0.001) Ⅰ+Ⅱ 93(69.4) 27.0±23.0 9.1±5.9 10.7±11.8 66.7±110.9 Ⅲ 41(30.6) 43.0±21.0 16.4±7.2 28.2±24.6 326.2±344.5 肿瘤
大小4.605(<0.001) 5.857(<0.001) 7.551(<0.001) 8.236(<0.001) ≥3 cm 73(54.5) 39.8±23.1 14.5±6.6 24.2±21.7 244.7±286.0 <3 cm 61(45.5) 22.3±21.6 7.6±6.0 6.3±5.1 32.7±82.7 病理
亚型6.026(<0.001) 5.912(<0.001) 2.634(0.008) 4.892(<0.001) 腺癌 89(66.4) 23.7±21.3 8.9±6.8 12.6±15.6 99.6±228.5 鳞状
细胞癌45(33.6) 49.0±18.3 16.1±5.3 22.8±21.2 243.8±241.1 淋巴结转移 3.908(<0.001) 4.610(<0.001) 2.997(0.003) 4.828(<0.001) 阴性 90(67.2) 42.3±20.1 9.3±6.6 12.6±16.1 98.9±194.9 阳性 44(32.8) 26.8±24.4 15.4±6.6 22.5±21.5 249.0±293.7 CT形态学特征 45.474(<0.001) 70.042(<0.001) 62.331(<0.001) 84.842(<0.001) 团块 70(52.2) 42.0±21.5 15.4±6.2 24.9±22.0 263.8±290.3 结节 43(32.1) 28.7±22.3 9.2±4.9 5.0±3.3 26.8±21.3 磨玻璃结节 21(15.7) 7.0±5.2 2.1±0.8 9.0±3.9 11.4±8.1 注:Ki-67为细胞增殖核抗原;FDG为氟脱氧葡萄糖;PET为正电子发射断层显像术;CT为计算机体层摄影术;SUVmax为最大标准化摄取值;MTV为肿瘤代谢体积;TLG为糖酵解总量 表 2 85例浸润型腺癌患者不同病理亚型的 Ki-67增殖指数、18F-FDG PET/CT代谢参数的比较(
)$ \bar x\pm s $ Table 2. Comparison of Ki-67 proliferation index and 18F-FDG PET/CT metabolic parameters in different pathological subtypes of 85 patients with invasive adenocarcinoma (
)$ \bar x\pm s $ 病理亚型 Ki-67(%) SUVmax MTV(cm3) TLG(g) 贴壁为主型(n=22) 9.0±7.0 3.9±3.7 7.5±4.2 16.8±20.4 腺泡为主型(n=28) 24.0±21.9 8.4±5.4 12.2±14.2 66.5±105.3 乳头状为主型(n=12) 18.0±13.0 7.4±4.1 8.9±7.1 46.4±55.3 微乳头状为主型(n=9) 41.0±19.0 16.0±8.9 17.1±16.9 257.0±444.6 实体为主型(n=14) 36.0±18.9 13.5±5.5 15.7±12.2 153.4±150.3 Z值 26.403 32.372 6.837 0.870 P值 <0.001 <0.001 0.145 0.929 注:Ki-67为细胞增殖核抗原;FDG为氟脱氧葡萄糖;PET为正电子发射断层显像术;CT为计算机体层摄影术;SUVmax为最大标准化摄取值;MTV为肿瘤代谢体积;TLG为糖酵解总量 表 3 85例不同分化程度浸润型腺癌患者的 Ki-67增殖指数、18F-FDG PET/CT代谢参数的比较(
)$ \bar x\pm s $ Table 3. Comparison of Ki-67 proliferation index and 18F-FDG PET/CT metabolic parameters in different differentiation degrees of 85 patients with invasive adenocarcinoma (
)$ \bar x\pm s $ 分化程度 Ki-67(%) SUVmax MTV(cm3) TLG(g) 高分化型(n=22, 贴壁为主型) 9.0±7.0 3.9±3.7 7.5±4.2 16.8±20.4 中分化型(n=40, 腺泡+乳头状为主型) 22.1±20.2 8.1±5.1 11.2±12.8 60.5±94.9 低分化型(n=23, 实体+微乳头状为主型) 37.5±19.7 14.4±7.3 16.3±14.6 194.0±312.9 Z值 21.074 21.410 1.903 13.983 P值 <0.001 <0.001 0.386 0.001 注:Ki-67为细胞增殖核抗原;FDG为氟脱氧葡萄糖;PET为正电子发射断层显像术;CT为计算机体层摄影术;SUVmax为最大标准化摄取值;MTV为肿瘤代谢体积;TLG为糖酵解总量 表 4 45例鳞状细胞癌患者不同病理亚型的 Ki-67增殖指数、18F-FDG PET/CT代谢参数的比较(
)$ \bar x\pm s $ Table 4. Comparison of Ki-67 proliferation index and 18F-FDG PET/CT metabolic parameters in different pathological subtypes of 45 patients with squamous cell carcinoma (
)$ \bar x\pm s $ 病理亚型 Ki-67(%) SUVmax MTV(cm3) TLG(g) 非角化型(n=19) 50.0±15.0 18.1±5.5 33.4±20.3 386.2±276.6 角化型(n=24) 43.0±18.0 14.7±5.6 19.1±23.3 189.9±222.6 基底样(n=2) − − − − Z值 2.096 1.736 2.177 2.494 P值 0.036 0.082 0.030 0.013 注:Ki-67为细胞增殖核抗原;FDG为氟脱氧葡萄糖;PET为正电子发射断层显像术;CT为计算机体层摄影术;SUVmax为最大标准化摄取值;MTV为肿瘤代谢体积;TLG为糖酵解总量。−表示无此项数据 表 5 85例浸润型腺癌患者不同病理亚型和分化程度的Ki-67增殖指数与18F-FDG PET/CT代谢参数的相关性
Table 5. Correlation of Ki-67 proliferation index and 18F-FDG PET/CT metabolic parameters in different pathological subtypes and differentation degrees of 85 patients with invasive adenocarcinoma
Ki-67增殖指数 SUVmax MTV TLG r值 P值 r值 P值 r值 P值 不同病理亚型浸润型腺癌 贴壁为主型(n=22) 0.568 0.006 0.042 0.852 0.576 0.005 腺泡为主型(n=28) 0.719 <0.001 −0.289 0.136 0.491 0.008 乳头状为主型(n=12) 0.795 0.002 0.212 0.508 0.477 0.017 微乳头状为主型(n=9) 0.179 0.645 0.409 0.275 0.230 0.552 实体为主型(n=14) 0.408 0.148 0.722 0.004 0.682 0.007 不同分化程度浸润型腺癌 高分化型(n=22,贴壁为主型) 0.568 0.006 0.042 0.852 0.576 0.005 中分化型(n=40,腺泡+乳头状为主型) 0.671 <0.001 −0.106 0.515 0.083 0.612 低分化型(n=23,实体+微乳头状为主型) 0.492 0.017 0.652 0.001 0.603 0.002 注:Ki-67为细胞增殖核抗原;FDG为氟脱氧葡萄糖;PET为正电子发射断层显像术;CT为计算机体层摄影术;SUVmax为最大标准化摄取值;MTV为肿瘤代谢体积;TLG为糖酵解总量 -
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